Article summary: symptom-based screening in Skilled Nursing Facilities could fail to identify half of residents with COVID19

Summary of a Morbidity and Mortality report by Kimball et al (see citation and link below).

The Centers for Disease Control and Prevention (US) tested 76 (93%) residents in a skilled nursing facility where there was an outbreak of COVID19.


  • 23 (30%) residents tested positive. Of these, 10 (43%) had symptoms on the date of the test. The remaining 13 (57%) were asymptomatic.
  • 7 days after testing, 10 out of 13 of the asymptomatic residents had developed symptoms


  • Symptom-based screening in long-term care facilities could fail to identify approximately half of residents with COVID19.


  • Once a facility has confirmed case of COVID19, all residents should be cared for using PPE, as asymptomatic and pre-symptomatic residents might contributed to transmission.


Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility — King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. ePub: 27 March 2020. DOI: icon.

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